Does Transfer Capacitive Resistive Energy Has a Therapeutic Effect on Peyronie's Disease? Randomized, Single-Blind, Sham-Controlled Study on 96 Patients: Fast Pain Relief.

Background/Aims/Objectives: We have investigated the clinical and physiological effects of Transfer Capacitive Resistive Energy (TCARE) therapy on men with Peyronie's disease (PD). METHODS: Ninety-six men with PD have been randomized in a 2:1 ratio to receive 3 sessions of TCARE therapy or sham therapy. Pain, penile curvature and erectile function have been assessed before the first treatment and up to 9 months after the end of treatment, using the Visual Analogue Scale for the pain, a goniometer to measure the degree of curvature using at-home photography and an International Index of Erectile Function (IIEF-5) questionnaire. RESULTS: A significant pain reduction at the end of the treatment in 51 (79.6%) patients (p < 0.01) of the treated group was observed. No significant improvements in the sham group (p = 0.23) have been observed. No statistical differences in the degree of curvature have been observed in both groups. No statistical improvements have been observed in the IIEF-5 questionnaire. Adverse events have not been reported. CONCLUSION: This is, to our knowledge, the first randomized, single-blind, sham-controlled study that shows that TCARE has a positive short-term clinical effect on pain in patients with PD. The feasibility and tolerability of this treatment produce an attractive new therapeutic option for men with PD.

Autonomic dysfunction in Parkinson disease.

In Parkinson disease (PD), symptoms and signs of autonomic failure occur commonly, especially in cardiovascular, gastrointestinal, and genitourinary domains. Most patients with PD have neuroimaging evidence of cardiac sympathetic denervation. In PD, orthostatic hypertension (OH) can be an early finding and is associated with extracardiac noradrenergic denervation and reduced baroreflex-cardiovagal and sympathoneural responses. Recognition of autonomic impairment is important because symptomatic treatment is frequently effective.

A Case of Hypervascularization of the Glans after Epigastrico-dorsal Vein Anastomosis / 대한비뇨기과학회지

We recently experienced a case of hypervascularization of the glans after arterialization of the deep dorsal vein(Furlow`s method) in a 25-year-old man having vasculogenic impotence due to arterial insufficiency of the penis. The Hypervascularization of the glans was corrected by ligating the branches of the deep dorsal Vein at the corona of the penis.

AVS(Audiovisual Stimulation)-Penogram / 대한비뇨기과학회지

In an effort to find more comprehensive and general diagnosis of erectile failure, we already have analysed 90 cases and reported the results. After that we added 199 more cases and performed a computer based analysis of total 289 cases in the dynamic changes of penile blood flow during natural physiologic erection after exposure to the audiovisual stimulation. The following results were obtained. 1. In normal volunteers, we were able to achieve uniform penogram findings in all cases with T.T.(Transit Time) ranging 1 to 3 minutes(mean 2.17 minutes), the EPT(Erection Persistent Time) over 30 minutes and no fluctuation phenomena after AVS. 2. Erectile failure group.(2.83 cases) (1) Group I.(108 cases; 38.2%). They demonstrated similar penogram features with the normal volunteers but EPT more than 5 minuets(mean 18.26 minutes) at least. most common causes were psychogenic origin(57 cases). (2) Group II.(175 cases ; 61.8%). Patients were showing abnormal penogram findings, and were divided into following 3 types. a) A type-Impossible type(10 cases ; 3.5%). They failed to show more than 2 fold increase in the maximal radioactivity after AVS when compared to the pre-stimuli level(mean 1.83 times). The underlying causes were identified to be arteriogenic and neurogenic. b) B type-Unstable type(124 cases ; 43.8%). They were unable to sustain erection due to fluctuation(mean 1.83 times). The underlying causes were psychogenic, vasculogenic and neurogenic origins. c) C type-Delayed type(41 cases ; 14.5%). They were showing T.T. more than 15 minutes(mean ; 23.71 minutes), and the underlying causes were arteriogenic, psychogenic and neurogenic origins. Based on these results, we have concluded that AVS-Penogram seems to the most appropriate diagnostic method for screening test and follow-up evaluation after vascular surgery. Through more clinical experience and investigation, and more comparison and analysis with other diagnostic methods, it will be a standard diagnostic approach in the future.

Long-term follow-up of Penile Prosthesis Implantation / 대한비뇨기과학회지

Forty eight patients with erectile failure were treated with penile prosthesis between December 1983 and March 1987 and following results were obtained. 1. The range of patient age was 23 to 75 years and the fifth decade(33.3%) was most common, followed by the fourth decade(25%) and the sixth decade(18.8%). 2. The etiology of erectile failure was spinal cord injury(31.3%), vasculogenic(27.1%), diabetes mellitus(22.9%) and radical cystectomy(8.3%). 3. The type of penile prosthesis was AMS malleable 600(62.5%), Jonas silicone silver(31.3%) and AMS Hydroflex(6.3%). The length of penile prosthesis was in the range of 13 to 21 cm and in 37 cases(77.1%) it was between 16 and 18 cm. The diameter of penile prosthesis was 9.5 mm(50%) and 11 - 11.5 mm(47.9%). 4. There were 4 cases of early complication ; prolonged pain in 2 cases and voiding difficulty in 2 cases were treated conservatively. There was 1 case of late complication ; the glans erosion in paraplegic patient. 5. Forty seven cases(97.9%) are now enjoying their sexual lives with penile prosthesis at follow-up of more than 3 months up to more than 3 years. From the above results, the implantation of penile prosthesis is a safe and effective method in the treatment of erectile failures.